Meningitis is a disease caused by the bacterial infection reaching the membranes covering the brain and the spinal cord. It causes the inflammation of the meninges and the subarachnoid cerebrospinal fluid (CSF). It is possible to divide the symptoms into acute, sub-acute and chronic categories.
Acute meningitis where the symptoms develop fast and within 24 hours is invariably from bacterial infection. Not all bacterial meningitis cases are acute. Nearly 75 percent of the bacterial meningitis cases are sub acute.
The emergency care involves in identifying and treating acute cases and making assessment of central nervous system infection in sub acute cases. There is a need to identify the organisms responsible for the infection. Factors such as virulence of the strain, defense mechanism of the body and bacteria-host interactions determine the speed at which the disease can develop in the patient.
As the inflammation of the meninges proceeds, this creates further complication in and around the brain such as weakening of the blood-brain barrier, cerebral edema and presence of toxic mediators in the CSF. Cerebral blood flow reduces and patient losses alertness. If medical intervention does not take place, the condition becomes worse and leads to the death of the patient.
The incidence of bacterial meningitis is 2-3 per 100,000 in the United States. Statistical data shows that there is increase among persons aged 60 and above. Pneumococcal meningitis is known to cause highest rate of mortality of 21 percent. The mortality rate can go up if severe neurological impairment has developed at the time of patient's admission and it is as high as 50-90 percent even with immediate medical treatment.
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